Pranjal Shah, M.D
Individual provider Active NPI Internal Medicine Physician · Woodridge, IL
NPI 1063602829 · NPPES record last updated Dec 6, 2021
Key facts
- NPI
- 1063602829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 36118963 (IL)
- Practice address
- 7530 Woodward Ave
Woodridge, IL 60517-3100 - Phone
- (630) 910-1177
- NPI assigned
- Jul 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Woodridge Clinic SC
Practice addresses (Care Compare)
805 S Main St
Lombard, IL 60148-2285
Phone (630) 620-6225
Hospital & facility affiliations
- Advocate Good Samaritan Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090625000164 | IL | Practitioner - Internal Medicine | 1456402874 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36118963 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodridge Clinic S.C | Current |
Accepting new patients |
Locations
3900 Gabrielle Ln
Unit 9130
Aurora, IL 60598
15884 W 127th St
Ste H
Lemont, IL 60439
Phone (630) 754-8710
805 S Main St
Lombard, IL 60148
Phone (630) 495-2333
7530 Woodward Ave
Woodridge, IL 60517
Phone (630) 427-1500
7530 Woodward Ave
Ste A
Woodridge, IL 60517
Phone (630) 910-1177
Interoperability endpoints
- pshah249153@direct.myadvocateaurora.org
- https://fhir4.healow.com/fhir/r4/ECFAAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36118963 | IL | Yes |
Addresses
Primary practice location
7530 Woodward Ave
Woodridge, IL 60517-3100
Mailing address
7530 Woodward Ave
Woodridge, IL 60517-3100
Phone (630) 910-1177
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pshah249153@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Woodridge, IL
- Seven Bridges Eye Care LLC
- Seven Bridges Surgical Facility
- Ashley Shah
- Dhimant Kaushik Shah
- Hiral Shah
- Debbie P Shanley
- Shawn Tenhouse DPM
- Kathryn Shay
- Kathleen Melei Sifuentes
- Dawn Louise Siil
All providers in Woodridge, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.